epilepsy Flashcards
if someone has 1 seizure after how long can they drive again in a car and HGV
car - 6 months
HGV - 5 years
if someone has epilepsy what is the criteria for them to drive a car and HGV
car - 1 year seizure free
HGV - 10 years seizure free and off medication
what is epilepsy
a tendency to have recurrent, usually spontaneous epileptic seizures
epileptic seizures - abnormal discharge of electricity that happens spontaneously
what is more common in epilepsy an excitatory or inhibiotry electrical discharge
excitatory
incidence of epilepsy
50-80/100,00 incidence a year
1/100-200 prevalence
most common neurological disorder
THOSE WITH EPILEPSY AT RISK OF SUICIDE
What type of seizures are seen in focal epilepsy
focal that can progress to general seizures
how would you describe a seizure if someone loses consciousness
discognitive
what are the different kinds of generalised seizures
absence myotonic atonic tonic tonic clonic
what lobe is invloved in sensory focal seizures
parietal lobe
what lobe is involved visual hallucinations or de je vu
temporal lobe
if focal seizure is motor what lobe is involved
frontal lobe
what age are the different type of epilepsy seen at
generalise - younger as tend to be genetic
partial - older as time to accumulate injury eg MS, tumour, trauma
treatment for generalised seizure 1st and 2nd line
1at - Sodium Valproate
2nd - Lamotrigene
treatment for focal epilepsy 1st and 2nd line
1st - Carbamazapine
2nd - Lamotrigene
mechanism of action for carbamazepine and lamotrigeen
sodium channel blocker
mechanism of action for sodium valproate
enhances GABA synthesis
what can be given alongside sodium valproate to enhance its efficacy
lamotrigene
after carbamazpine and lamotrigene what are examples of drugs that can be added on
oxycarbazepine levetoracitam topiramate gabapentin pregabalin clonazepam phrnytoin
what is given 2nd line in absent seizures
ethosuximide
what is given 2nd line in myoclonic seizure
levetoracitam
sodium valproate side effects
teratogenic
weight gain
hair loss
fatigue
LOTS OF OTHERS
carbamazepine side effects
dizziness
side effect of lamotrigene
stevens johnson syndrome
topiramate side effects
weight loss and psychiatric problems
what is STATUS EPILEPTICUS
recurrent epileptic siezures without full recovery of consciousness lasting more than 30 mins
after how many mins of status is treatment initiated
10 mins
what are the different types of status epilepticus and explaine each a little
generalised convulsive status epilepticus (tonic clonic )
non convulsive status (partial epilepticus -conscious but not with it )
epilepsia partialis continua - continuous focal seizures but retained consciousness
what is the worst kind of status
generalise convulsive status
excitotoxicity and neuronal death after glutamate release
management of a convulsive status epilepticus
after 10 mins benzo admin if doesn't work benzo again phenytoin( if unavail then Na VAlproate or levitoracitam ) if nto CALL ICU
what benzos and what dose can be given in status
IV lorazepam 4mg
buccal midazolam 10mg
rectal diazepam 10mg
what is name for a functional seizure
psychogenic non-epileptic attack disorder
